Perspectives in Non-Invasive Brain Stimulation and Neuromodulation

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About this Research Topic

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Background

Transcranial magnetic stimulation (TMS) was first described by Barker, Freeston, and Jalinous more than three decades ago. It was based on the induction of electrical currents in the nervous tissue, and remarkably, it was completely painless.

Although initially intended to obtain motor evoked potentials in demyelinating diseases of the Central Nervous System, further studies have shed light on its potential to modulate neuronal excitability. Pascual-Leone was one of the first researchers to show how TMS sessions could have a therapeutic effect on patients with drug-resistant forms of depression.

An older form of transcranial electrical stimulation known as "brain polarization", was described back in the '60s. The “brain polarization” technique consisted of weak direct currents applied through the skull. These currents were able to influence neuronal membrane potentials in vitro. A few studies described the technique’s apparent therapeutic effectiveness in psychiatric patients, but, due to the rapid development of psychopharmacology, it was virtually forgotten for many decades.

It was just recently, however, that the brain polarization technique, now called transcranial direct current stimulation (tDCS), attracted renewed interest, thanks to the demonstration of the effect of repeated TMS sessions upon cerebral excitability. There have been numerous efforts to establish the utility of repetitive TMS (rTMS) and tDCS sessions in the clinical setting. However, most published studies were limited by the small number of patients, and there is still a lack of evidence coming from large, controlled trials for many neurological and psychiatric conditions investigated so far.

A few attempts at making sense of the vast number of small studies and of the few controlled trials are noteworthy: the two European consensus papers on the uses of rTMS and a similar review regarding tDCS.

The use of rTMS for the treatment of major depression and chronic pain is already well supported by the scientific literature, but tDCS is still lacking more robust confirmation of its true therapeutic potential. Moreover, based on the principle that most neuropsychiatric disorders involve hyper or hypo-excitability impacting different cortical areas, both techniques have been extensively investigated in many different clinical contexts.

This Research Topic aims to bring together new perspectives on the clinical utility of rTMS and tDCS in the treatment of neurological and psychiatric conditions and provide a better understanding of the link between the underlying brain network modulation and the clinical response.

Contributions will focus on technical details, innovative clinical applications, new protocols of treatment (alone or in combination), new evidence of efficacy, as well as attempts at integrating the available evidence concerning clinical applications of rTMS and tDCS.


Dr Marcel Simis is co-founder of "HealthBiz" company. Dr Michael Nitsche is part of the Scientific Advisory board for Neuroelectrics. The other Topic Editors declare no competing interests with regards to the Research Topic subject.

Keywords: rTMS, tDCS, therapeutic, neuropsychiatric disorders, excitability, cortical areas, neurological conditions, brain network modulation, clinical response

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